餐厅菜单添加糖警示标签的在线 RCT
Online RCT of Icon Added-Sugar Warning Labels for Restaurant Menus.
机构信息
Human Development and Family Studies Program, Department of Human Ecology, University of California, Davis, Davis, California.
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
出版信息
Am J Prev Med. 2023 Jul;65(1):101-111. doi: 10.1016/j.amepre.2023.02.007. Epub 2023 Apr 17.
INTRODUCTION
To reduce added-sugar consumption, jurisdictions are considering requiring restaurant menu labels to identify high-added-sugar items. This study examined the impacts of added-sugar warning labels on hypothetical choices, knowledge of items' added-sugar content, and perceptions of high-added-sugar items.
STUDY DESIGN
The design was an online RCT.
SETTING/PARTICIPANTS: National sample of adults (N=15,496) was recruited to approximate the U.S. distribution of sex, age, race, ethnicity, and education.
INTERVENTION
Participants viewed fast-food and full-service restaurant menus displaying no warning labels (control) or icon-only added-sugar warning labels next to high-added-sugar items (containing >50% of the daily recommended limit).
MAIN OUTCOME MEASURES
The main outcome measures were hypothetical ordering of ≥1 high-added-sugar item, grams of added sugar ordered, and knowledge of items' added-sugar content assessed in 2021 and analyzed in 2021-2022.
RESULTS
Warning labels reduced the relative probability of ordering ≥1 high-added-sugar item by 2.2% (probability ratio=0.978, 95% CI=0.964, 0.992; p=0.002); improved knowledge of added-sugar content (p<0.001); and led to a nonstatistically significant reduction of 1.5 grams of added sugar ordered, averaged across menus (p=0.07). The label modestly reduced the appeal of high-added-sugar items, increased perceptions that consuming such items often will increase Type 2 diabetes risk, increased perceived control over eating decisions, and increased injunctive norms about limiting consumption of high-added-sugar items (ps<0.001). However, in the warning condition, only 47% noticed nutrition labels, and 21% recalled seeing added-sugar labels. When restricting the warning condition to those who noticed the label, the result for grams of added sugar ordered was significant, with the warning condition ordering 4.9 fewer grams than the controls (95% CI= -7.3, -2.5; p<0.001).
CONCLUSIONS
Added-sugar warning labels reduced the probability of ordering a high-added-sugar menu item and increased participants' knowledge of whether items contained >50% of the daily value for added sugar. The modest magnitudes of effects may be due to low label noticeability. Menu warning labels should be designed for noticeability.
REGISTRATION
This study was registered at AsPredicted.org #65655.
简介
为了减少添加糖的摄入量，各司法管辖区正在考虑要求餐厅菜单标签标识高添加糖的项目。本研究考察了添加糖警告标签对假设选择、对项目添加糖含量的了解以及对高添加糖项目的看法的影响。
研究设计
该设计是一项在线 RCT。
地点/参与者：全国成年人样本（N=15496）被招募以近似美国的性别、年龄、种族、族裔和教育分布。
干预措施
参与者查看了没有警告标签（对照）或仅带有图标添加糖警告标签的快餐店和全方位服务餐厅菜单，旁边是高添加糖项目（含有每日推荐限量的>50%）。
主要结果测量
主要结果是在 2021 年评估并在 2021-2022 年分析的假设至少订购 1 种高添加糖项目、订购的添加糖克数以及对项目添加糖含量的了解。
结果
警告标签使≥1 种高添加糖项目的相对订购概率降低了 2.2%（概率比=0.978，95%CI=0.964，0.992；p=0.002）；提高了对添加糖含量的了解（p<0.001）；并且平均而言，菜单上的添加糖订购量减少了 1.5 克，这一结果无统计学意义（p=0.07）。标签适度降低了高添加糖项目的吸引力，增加了人们认为经常食用此类项目会增加 2 型糖尿病风险的看法，增加了对饮食决策的控制感，并增加了限制高添加糖项目消费的禁令规范（p<0.001）。然而，在警告条件下，只有 47%的人注意到营养标签，只有 21%的人记得看到添加糖标签。当将警告条件限制在注意到标签的人中时，订购的添加糖克数的结果是显著的，警告条件比对照组少订购 4.9 克（95%CI=-7.3，-2.5；p<0.001）。
结论
添加糖警告标签降低了订购高添加糖菜单项目的可能性，并增加了参与者对项目是否含有>50%每日添加糖值的了解。影响的适度幅度可能是由于标签的可见性低。菜单警告标签应设计为易于察觉。
注册
本研究在 AsPredicted.org #65655 上注册。
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